Apr 20, 2018

Quality Analyst Houston, TX, US Requisition ID : 1277

  • Veterans Evaluation Services, Inc
  • Houston, TX, US
Full-Time Administration Facilities Health Care Insurance QA-Quality Control

Job Description

Quality Analyst

Regular Full-TimeClerical

Houston, TX, US

3 months ago

Requisition ID : 1277

General Job Summary:
The primary responsibility of a Quality Analyst (“QA”) is to review Medical Disability Examination (“MDE”) reports and Disability Benefits Questionnaires (“DBQs”) generated by medical providers on Veterans evaluated on behalf of the Department of Veterans Affairs (the “VA”).  A QA works closely with medical providers to ensure MDE reports and DBQs are consistent with the quality and timeliness requirements of the VA. 

Essential Job Functions:

  1. Adhere to the company’s Standard of Conduct at all times, in all job functions;
  2. Exercise independent discretion and decision-making on behalf of the company with regard to medical provider interaction and relationships;
  3. Review MDE requests from the VA to ensure that all claims made by a Veteran to be evaluated are properly reflected on the appropriate DBQ(s);
  4. Review MDE reports and DBQs submitted by medical providers for typographical and grammatical errors, and internal consistency and continuity, ensuring that each has been fully completed and meets the requirements of the VA, including, but not limited to, ensuring that all claims made by a Veteran have been addressed on the appropriate DBQ and that the medical provider has rendered a diagnosis or a statement explaining why a diagnosis is not warranted;  
  5. Communicate with medical providers regarding their MDE reports and DBQs and, at the discretion and direction of the medical provider, facilitate any necessary corrections, prior to submission to the VA; 
  6. Verify that any special requests or necessary second reviews have been completed, consistent with the VA’s preferences;
  7. Ensure that all diagnostics requested by the medical provider have been completed, reviewed by the medical provider, and are submitted with the final report; 
  8. Perform daily queue maintenance to ensure that every case assigned has any updated notes and any needed action has been taken;
  9. Communicate with the Medical Advisory Board on any case that needs additional review, may be outside the scope of the assigned medical provider’s training or expertise, or has presented a problem/issue with the assigned medical provider;
  10. Assist Provider Training team with ongoing training and development of medical providers by reporting all problematic medical provider trends/issues; and
  11. Consistently achieve weekly/monthly qualitative and quantitative goals set by management.

Additional Duties and Responsibilities:

  1. Answer phone calls from medical providers; 
  2. Attend meetings as directed;
  3. Communicate and assist other departments in a collaborative effort to expedite cases;
  4. Work effectively within a team dynamic;
  5. Adapt to new instructions, requests or procedures as provided;
  6. Maintain a high sense of urgency at all times; 
  7. Ensure the confidentiality of Veterans’ records; and
  8. Other duties as assigned.


Knowledge/Skills/Abilities:

  1. Self-starter;
  2. Intermediate knowledge of pertinent medical terminology;
  3. Advanced verbal and interpersonal skills;
  4. Advanced written communication skills, to include excellent grammar;
  5. Advanced reading and comprehension abilities;
  6. Advanced analytical skills and detail-oriented;
  7. Advanced multi-tasking skills;
  8. Advanced organizational and prioritization skills, with strong ability to meet strict deadlines with minimal supervision;
  9. Proficient typing skills; and
  10. Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel. 


Working Conditions:

  1. Casual office environment, with some exposure to mild noise from office equipment and moderate noise generated by staff members; and 
  2. Frequently utilizes phone, fax machine, computer, printer, and copy machines.


Minimum Level of Preparation and Training:
Bachelor’s degree or equivalent experience required.

PLEASE CLICK ON LINK BELOW TO BE DIRECTED TO OUR WEBSITE FOR YOUR APPLICATION PROCESS:  https://workforcenow.adp.com/mdf/recruitment/recruitment.html?cid=8db088e2-822f-4105-a5de-69ad6c4e7b84&ccId=19000101_000001&type=MP&lang=en_US

States

TX  

Security Clearance

NO Security Clearance

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